@article{fdi:010077137,
  title = {{R}esidual or recurrent precancerous lesions after treatment of cervical lesions in {H}uman {I}mmunodeficiency {V}irus-infected women : a systematic review and meta-analysis of treatment failure},
  author = {{B}eaudrap, {P}ierre de and {S}obngwi, {J}. and {T}ebeu, {P}. {M}. and {C}lifford, {G}. {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {S}creening and treating premalignant cervical lesions (cervical intraepithelial neoplasia 2+ [{CIN}2+]) is an effective way to prevent cervical cancer, and recommendations exist for the monitoring of treatment success. {Y}et, there is no specific recommendation for human immunodeficiency virus ({HIV})-infected women, who are at a known, increased risk of cervical cancer. {M}ethods. {A} systematic review was performed by searching {MEDLINE}, {EMBASE}, and {W}eb of {S}cience for studies published from {J}anuary 1980 through {M}ay 2018. {E}ligible studies described the prevalence of histologically- and/or cytologically-defined lesions in {HIV}-infected women at least 6 months post-treatment. {T}he primary endpoint was treatment failure, defined as the presence of residual and/or recurrent high-grade {CIN}2+/high-grade squamous intraepithelial lesions post-treatment. {T}he pooled prevalence in {HIV}-infected women and the odds ratios ({OR}s) for {HIV}-infected compared to {HIV}-uninfected women were estimated using random-effects models. {R}esults. {A}mong 40 eligible studies, the pooled prevalence of treatment failure in {HIV}-infected women was 21.4% (95% confidence interval [{CI}] 15.8-27.0). {T}here was no significant difference in the treatment failure prevalence for cryotherapy (13.9%, 95% {CI} 6.1-21.6) versus loop electrosurgical excision procedure (13.8%, 95% {CI} 8.9-18.7; {P} = .9), but the treatment failure prevalence was significantly higher in women with positive (47.2%, 95% {CI} 22.0-74.0) than with negative (19.4%, 95% {CI} 11.8-30.2) excision margin ({OR} 3.4, 95% {CI} 1.5-7.7). {T}reatment failure was significantly increased in {HIV}-infected versus {HIV}-uninfected women, both overall ({OR} 2.7, 95% {CI} 2.0-3.5) and in all sub-group analyses. {C}onclusions. {T}here is strong evidence for an increased risk of treatment failure in {HIV}-infected women, in comparison to their {HIV}-negative counterparts. {T}he only significant predictor of treatment failure in {HIV}-infected women was a positive margin status, but further data is needed on long-term outcomes after ablative treatment in {HIV}-infected women.},
  keywords = {human immunodeficiency virus ; human papillomavirus ; cervical cancer ; treatment failure ; meta-analysis},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {69},
  numero = {9},
  pages = {1555--1565},
  ISSN = {1058-4838},
  year = {2019},
  DOI = {10.1093/cid/ciy1123},
  URL = {https://www.documentation.ird.fr/hor/fdi:010077137},
}